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Dementia and Gambling

In 2013 the gambling industry reported that more than half of its customers are 50 years and older. David Oslin at the University of Pennsylvania reports that 70 percent of the older adults 65 years and older had gambled in the previous year and that one in 11 had bet more than he or she could comfortably afford to lose. Using this percentage—despite older adults having the lowest rate of pathological gambling—in 2013, there were potentially more than four million older adults with a gambling problem.

Although there is very little independent research—that which is not sponsored by the gambling industry—on pathological gambling older adults, what we know is that they are likely to have poor mental and physical health and have less income. Although these are not the cases that make the news, these are the gamblers that fuel the profit margins of the gambling industry.

Most older adults are hesitant talking about their addiction—as Oslin found when half refused to participate. Most will not come out of the closet since it involves money-secrets at both ends. How you obtain money to gamble and what you do with the losses or the wins. For addicted gamblers both the winning and losing are highs, either way, casinos always profit. Casinos will not make a profit if they do not have compulsive gamblers. The Wall Street Journal reports how Harrah's Entertainment Inc. in 2007 derived 5.6% of its Las Vegas gambling revenue from just one man, Mr. Terry Watanabe—despite their competitor Steve Wynn barring Mr. Watanabe because he was a compulsive gambler and alcoholic.

Pathological gambling, or Gambling Disorder (GD)—as the DSM-V defines it now—is characterized by consistent, repetitive gambling and unsuccessful attempts at quitting. GD is seen an impulse control disorder and has been reported in patients with Parkinson's disease, frontotemporal dementia, and amyotrophic lateral sclerosis.

However, there is no comprehensive study of how many patients with dementia gamble. Studies that show the benefits of gambling among nursing home patients do not report control studies or the amount of money being gambled and lost. There are also inconclusive results about the effect of dementia or Parkinson’s medication. One outcome is certain however. Gambling disorder responds to medication—either positive or negative. While 30-50 percent of adults with gambling disorders also have substance abuse—medication (such as opioid antagonists) used to treat drug and alcohol dependence also seems to work for gambling addiction.

Gambling Disorder (GD) is argued to be different from recreational gambling. However with an increasing aging population that exhibit more and more cognitive decline and impairment, the lines are becoming blurred. But this is not a no-cost venture. Older adults are unlikely to recover lost savings, while their families are usually the ones left without any resources. In the award winning and highly readable 2013 book “Addiction by Design”, anthropologist Natasha Dow Schüll from Massachusetts Institute of Technology defines exactly how slot machines, and the casinos that contain them, are designed specifically to create addiction and encourage their users to 'play to extinction'.

David Oslin says that 70 percent of those over 65 have gambled during the past year. What is his definition of gambling? Going to the casino? Playing the lottery?
I've been to a casino once this past year but I also play the lottery every week.

Yes, you are absolutely right, but if you continue with the qualifier of the sentence "...and that one in 11 had bet more than he or she could comfortably afford to lose." the point I wanted to make is that this is not just entertainment. When you play the lottery you know the cost up front. Gambling in a casino --unless you set yourself limits--you do not have such limits. Frail and vulnerable people might not be in a position to make that judgement.